TY  - THES
A1  - Brandt, Gregor A.
T1  - Gait Initiation in Parkinson's Disease: The Interplay of Dopamine and Postural Control
T1  - Der erste Schritt bei M. Parkinson: Der Zusammenhang zwischen Dopamin und posturaler Kontrolle
N2  - Deterioration of gait and alterations of physiological gait initiation contribute significantly to the burden of disease in Parkinson's disease. This paper systematically investigates disease-specific alterations during the postural phases of gait initiation and demonstrates the influence of dopaminergic networks by assessing levodopa mediated improvements in motor performance and correlation of motor behavior with loss of striatal and cortical dopaminergic neurons. Particular attention is given to known confounders such as initial stance and anthropometrics.
N2  - Störungen des Gangbildes und Veränderungen der physiologischen Bewegungsabläufe während des ersten Schrittes tragen einen signifikanten Teil zur Krankheitslast der Parkinsonerkrankung bei. Diese Veröffentlichung untersucht systematisch die krankheitsspezifischen Veränderungen der posturalen Phase des ersten Schrittes und demonstriert den Einfluss dopaminerger Netzwerke durch Untersuchungen Levodopa-induzierter Verbesserungen des Bewegungsablaufs und Korrelationen des Bewegungsverhaltens mit dem Verlust striataler und kortikaler dopaminerger Neuronen. Besondere Sorgfalt wurde bekannten modifizierenden Faktoren wie initaler Standbreite und anthropometrischen Größen zu Teil.
KW  - Parkinson-Krankheit
KW  - Parkinson's Disease
KW  - Gait initiation
KW  - Motor Control
KW  - Dopamine
Y1  - 2020
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-214636
ER  - 
TY  - JOUR
A1  - Palmisano, Chiara
A1  - Brandt, Gregor
A1  - Vissani, Matteo
A1  - Pozzi, Nicoló G.
A1  - Canessa, Andrea
A1  - Brumberg, Joachim
A1  - Marotta, Giorgio
A1  - Volkmann, Jens
A1  - Mazzoni, Alberto
A1  - Pezzoli, Gianni
A1  - Frigo, Carlo A.
A1  - Isaias, Ioannis U.
T1  - Gait Initiation in Parkinson’s Disease: Impact of Dopamine Depletion and Initial Stance Condition
JF  - Frontiers in Bioengineering and Biotechnology
N2  - Postural instability, in particular at gait initiation (GI), and resulting falls are a major determinant of poor quality of life in subjects with Parkinson’s disease (PD). Still, the contribution of the basal ganglia and dopamine on the feedforward postural control associated with this motor task is poorly known. In addition, the influence of anthropometric measures (AM) and initial stance condition on GI has never been consistently assessed. The biomechanical resultants of anticipatory postural adjustments contributing to GI [imbalance (IMB), unloading (UNL), and stepping phase) were studied in 26 unmedicated subjects with idiopathic PD and in 27 healthy subjects. A subset of 13 patients was analyzed under standardized medication conditions and the striatal dopaminergic innervation was studied in 22 patients using FP-CIT and SPECT. People with PD showed a significant reduction in center of pressure (CoP) displacement and velocity during the IMB phase, reduced first step length and velocity, and decreased velocity and acceleration of the center of mass (CoM) at toe off of the stance foot. All these measurements correlated with the dopaminergic innervation of the putamen and substantially improved with levodopa. These results were not influenced by anthropometric parameters or by the initial stance condition. In contrast, most of the measurements of the UNL phase were influenced by the foot placement and did not correlate with putaminal dopaminergic innervation. Our results suggest a significant role of dopamine and the putamen particularly in the elaboration of the IMB phase of anticipatory postural adjustments and in the execution of the first step. The basal ganglia circuitry may contribute to defining the optimal referent body configuration for a proper initiation of gait and possibly gait adaptation to the environment.
KW  - gait initiation
KW  - Parkinson’s disease
KW  - basal ganglia
KW  - dopamine
KW  - base of support
KW  - anthropometric measurements
Y1  - 2020
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-200801
SN  - 2296-4185
VL  - 8
ER  -